Morrison and colleagues’ commentary raises a number of points worthy of serious consideration. Essentially, the authors question the reflexive use of antipsychotics as the primary, and sometimes only, ongoing treatment for schizophrenia and psychosis, in light of recent research regarding efficacy, toxicity, and the availability of non-pharmacological alternatives.

If we were to take these issues seriously in the context of research, what might the logical next steps be? The disconnect between long-term outcome studies (e.g., Harding et al., 1987a; Harding et al., 1987b; Harrow et al., 2012), in which a substantial percentage of individuals in functional recovery or remission report no longer taking antipsychotics, and shorter-term efficacy studies (e.g., Emsley et al., 2012; Gaebel et al., 2011), suggesting a generalized global benefit to continuous pharmacotherapy, underscores the many important unanswered questions regarding antipsychotic use over the lifespan. What, for example, are the neural and behavioral mechanisms and correlates of periods of recovery and/or remission occurring in the absence of medication? Are there important differences between early-course (i.e., 0-4 years post-onset) and middle or later-course schizophrenia vis-à-vis medication efficacy, necessity, and risk/benefit tradeoffs? Aside from the relatively limited individual-level variables suggested by Harrow and colleagues, what biological, social, and structural factors predict "successful" medication discontinuation? What are the best "treatments" for individuals at any stage of illness who refuse antipsychotics (and how do they "work" in the absence of medications)?

Although the ethics of randomization to a longer-term medication discontinuation condition remain questionable, it seems unambiguous that researchers could be doing more to investigate "naturalistic" long-term trajectories of medication (dis)use and recovery, examine differences between subgroups (utilizing, e.g., latent class growth curve modeling), make better use of matched control designs, and actively recruit and include individuals who have discontinued antipsychotics and/or disengaged with the mainstream mental health system as research participants.

Such efforts would not only help elucidate issues of obvious importance to psychiatric researchers, but also demonstrate a sensitivity to issues that mental health activists and advocates have long emphasized.